Healthcare Provider Details

I. General information

NPI: 1710290432
Provider Name (Legal Business Name): MONICA SLINKARD PHILIPP APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MONICA SARAH SLINKARD APRN

II. Dates (important events)

Enumeration Date: 07/22/2010
Last Update Date: 03/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

789 HOWARD AVE
NEW HAVEN CT
06519-1304
US

IV. Provider business mailing address

789 HOWARD AVE
NEW HAVEN CT
06519-1304
US

V. Phone/Fax

Practice location:
  • Phone: 203-688-5555
  • Fax:
Mailing address:
  • Phone: 203-688-5555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number6567
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number6567
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: